Abstract:
BACKGROUND:The International Study Group on Pancreatic Fistula (ISGPF) classification scheme has become a useful system for characterizing the clinical impact of pancreatic fistula. We sought to identify predictive factors that predispose patients to fistula, specifically those with clinical relevance (grades B/C), and to describe the clinical and economic significance of risk stratification within this framework. METHODS:Overall, 233 consecutive pancreatoduodenectomies were performed between October 2001 and March 2007 in our institution. Pancreatic fistula is defined according to the ISGPF classification scheme. Logistic regression analysis was performed to identify risk factors for pancreatic fistula development. These features were then analyzed to determine whether additive risk severity equates to worsening clinical and economic impact. RESULTS:Fistulas of any extent occurred in 60 patients, but only 31 (14%) were clinically relevant. There are no identifiable risk factors for grade A biochemical fistulas. Multivariate analysis shows that small pancreatic duct size (<3 mm); soft gland texture; ampullary, duodenal, cystic, or islet cell pathology; and increased intraoperative blood loss (>1,000 ml) are associated with clinically relevant fistulae. An additive effect is further illustrated, in which clinical and economic outcomes progressively worsen as risk profile increases. Each additional risk factor increases the odds of developing a clinically relevant fistula by 52%. CONCLUSIONS:For pancreatoduodenectomy, small duct size; soft gland texture; ampullary, duodenal, cystic, or islet cell pathology; and increased intraoperative blood loss are convincing risk factors for the development clinically relevant fistulae as judged by ISGPF classification. As risk profile accrues, patients suffer more complications, encounter longer hospital stays, and incur greater hospital costs. These outcomes can be predicted in the operating room through accurate delineation of high-risk glands.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Pratt WB,Callery MP,Vollmer CM Jrdoi
10.1007/s00268-007-9388-5subject
Has Abstractpub_date
2008-03-01 00:00:00pages
419-28issue
3eissn
0364-2313issn
1432-2323journal_volume
32pub_type
杂志文章abstract:BACKGROUND:The aim of this study was to evaluate and investigate the complications of carotid endarterectomy (CEA) and carotid artery stenting (CAS) by performing a meta-analysis based on prospective randomized controlled trials (RCTs). METHODS:We performed a search of multiple electronic databases for RCTs containing...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00268-008-9862-8
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Sentinel lymph node biopsy (SLNB) plays an essential role in the evaluation of lymph node (LN) metastasis status and the extent of LN dissection in gastric cancer. The aim of our study was to perform a systematic review and meta-analysis for corresponding identification rate and sensitivity of different SLNB...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-020-05900-9
更新日期:2021-01-03 00:00:00
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journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:1992-01-01 00:00:00
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abstract:BACKGROUND:Neurosurgical capacity is extremely deficient in East African countries where 27 neurosurgeons serve more than 250 million people. To build capacity, the Duke University Medical Center and New Mulago Hospital in Uganda applied a two-pronged twinning approach that placed usable surplus equipment in a developi...
journal_title:World journal of surgery
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更新日期:2014-12-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2016-05-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
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更新日期:2013-01-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2015-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2016-08-01 00:00:00
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journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002680020017
更新日期:2001-02-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900332
更新日期:1997-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7849-2
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pub_type: 杂志文章
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更新日期:2010-07-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658863
更新日期:1989-09-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:1995-05-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/pl00012343
更新日期:1999-06-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-014-2938-8
更新日期:2015-04-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002680010238
更新日期:2000-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-0594-8
更新日期:2007-01-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2019-04-01 00:00:00